Head trauma and TBI Flashcards
5 Extracranial priorities
Airway obstruction oxgenation ventilation volume status penetrating wounds
Three things to check during initial neuro exam (measured in Modified Galscow Coma Scale)
Level of consciousness
Motor activity
brain stem reflexes
Percentage of cardio output brain recieves
15-20%
Primary energy source for the brain
Glucose
What range should MAP be
50-150mmHg
Are primary or secondary injuries easier to fix
Secondary
What is the most important determinant of outcome for TBI
severity of secondary injury
What happens during secondary TBI
TBI triggers a series of biochemical events ultimately resulting in neuronal cell death at local and distant sites from the primary injury
What are 5 extra-cranial effects of TBI
BP alterations Anemia Hypercapnia Infection Electrolyte abnormalities
What are 3 intracranial alterations of secondary TBI
Ischemia
Cerebral edema
Increase ICP (ideally <30)
How do you calculate cerebral perfusion pressure
CCP= Mean arterial pressure - intracranial pressure
What is cerebral perfusion pressure
Force driving blood into the calvarium and providing the brain with oxygen and nutrients
What happens during the Cushing’s reflex
Increased intracranial pressure causes reflex bradycardia and hypertension
Emergency diagnostic tests for TBI
Acid base status Ventilation(CO2) Perfusion (lactate) electrolytes Glucose Renal values
Cardiovascular and respiratory assessment for TBI
Blood pressure SpO2 Capnography Radiographs Afast Tfast
